Abstract

The incremental shuttle walk (ISW) is well validated in COPD but limited psychometric data restrict its use in idiopathic pulmonary fibrosis (IPF). Study 1: 50 patients performed the ISW and 6 min walk test (6MWT). Study 2: 72 patients completed the ISW before and after pulmonary rehabilitation (PR). The ISW correlated strongly with 6MWT distance (r=0.81,p<0.0001). Mean (95% confidence interval) improvement in ISW with PR was 54 (38 to 70) m with an effect size of 0.29. Distribution-based and anchor-based minimum clinically important difference (MCID) estimates ranged from 31 to 46 m. The ISW is valid and responsive in IPF, with an anchor-based MCID estimate similar to that observed in chronic obstructive pulmonary disease.

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Footnotes

Contributors CMN and VD contributed equally to this study. CMN and WDCM substantially contributed to the conception and design of the study, prepared the first draft of the manuscript and agreed to be accountable for all aspects of the work. CMN, VD, SP, REB and SEJ contributed equally to the acquisition of data. CMN, VD and WDCM were responsible for the analysis and interpretation of the data. All authors equally contributed to the revision of the manuscript critically for important intellectual content and approval of the final manuscript.

Funding This work was supported by a National Institute for Health Research Doctoral Research Fellowship (DRF-2017-07-089) awarded to CMN.

Competing interests VD, SP and REB are funded by the NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College. VD is funded by NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London. MM is supported by Cicely Saunders International and CLAHRC for South London. SSCK is funded by The Hillingdon Hospital and The Royal Brompton and Harefield NHS Foundation Trust. TMM is supported by an NIHR Clinician Scientist Fellowship (NIHR Ref: CS-2013-13-017). WDCM is partly funded by the NIHR CLAHRC for NW London. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. All other author have no competing interest to declare.

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